CPAP Business Requirements Updated

If you’ve lost sleep trying to interpret the Continuous Positive Airway Pressure (CPAP) business requirements policy the Centers for Medicare & Medicaid Services (CMS) published July 25 in Transmittal 91, get ready for some well-deserved rest. CMS Transmittal 94, Change Request 6048, released August 29, clarifies wording in the policy.

Transmittal 91 notified Medicare providers and suppliers that, effective March 13, 2008, CPAP therapy for obstructive sleep apnea rendered to Medicare patients is considered medically necessary and covered by Medicare when ordered by the treating physician.

Although no changes to the national coverage determination (NCD) are made in Transmittal 94, physicians and staff should read the latest version of the business requirements policy to ensure compliance.